MEDICARE: MAREAN VASQUEZ APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	11043961	FL

General Provider Information

NPI Number	:	1376406322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAREAN VASQUEZ APRN

Provider Business Mailing Address
First Line	:	1038 11TH ST APT 15
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-4893
Country	:	US
Telephone Number	:	305-609-8032
Fax Number	:

Provider Business Practice Location Address
First Line	:	1038 11TH ST
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-4857
Country	:	US
Telephone Number	:	305-609-8032
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2025
Last Update Date	:	12/09/2025

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